IPOM ventral hernia repair - Pros & Cons

The laparoscopic intraperitoneal onlay mesh (IPOM) repair introduced in the late 1990s used to be the choice of MIS repair for all ventral hernias, aiming to reduce the invasiveness associated with traditional open procedures. Over time, the IPOM technique has undergone evolution, and the broader adoption of laparoscopic hernia repair techniques gained momentum in the late 20th century.

Various surgeons, notably Dr. Karl LeBlanc from the United States, have significantly contributed to the development and refinement of laparoscopic hernia repair techniques, including IPOM. Conventionally, laparoscopic ventral hernia repair involves the fixation of an intraperitoneal mesh to the abdominal wall using tackers and/or transfascial sutures.

Despite its conventional use, the IPOM approach has faced declining popularity in recent years due to rare but severe complications such as intestinal adhesions to the mesh (even the coated mesh) and chronic pain suggestively associated with the traumatic mesh fixation. Moreover, expert consensus-based guidelines recommended retromuscular mesh placement, highlighting the preference for this approach.

The rise of robotic platforms in high-income countries has facilitated the adoption of more technically advanced minimally invasive procedures, allowing mesh placement outside the peritoneal cavity without the need for traumatic fixation. Yet, in many groups, IPOM repair remains the preferred choice for MIS ventral hernia repair and they challenge the negative perception of the IPOM technique and argue with very low rates of mesh-related complications.

There seems to be a divide between those who still advocate for IPOM repairs and those who reject the technique. A more concise and data-driven perspective on the efficacy of the IPOM technique is needed for a clearer understanding of its role in MIS ventral hernia repair.

We invite all interested authors to submit their papers, here are some suggestions for topics:

- Results after IPOM vs. other minimally invasive procedures
- IPOM vs open ventral hernia repair
- In which situations is IPOM the best choice?
- Benefits of IPOM repair
- Downsides for IPOM repair
- How to perform a good IPOM repair
- Different fixation techniques for IPOM repair
- Patient perspectives IPOM
- Complications after IPOM
- Editorial/Opinion articles

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This Special Issue accepts the following article types, unless otherwise specified in the Special Issue description:

• Brief Research Report
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Article types

This Special Issue accepts the following article types, unless otherwise specified in the Special Issue description:

• Brief Research Report
• Case Report
• Commentary
• Editorial
• Letter to the Editor
• Mini Review
• Opinion
• Original Research
• Protocol
• Review

Keywords: Ventral hernia, IPOM, MIS, Intraperitoneal mesh, laparoscopic ventral hernia repair